原发性肝癌中医证型与血清AFP及VEGF相关性初步研究

Preliminary Study on the Relationship Between TCM Syndromes of Primary Liver Cancer and Serum AFP and VEGF

目的:初步研究原发性肝癌(primary liver cancer,PLC)常见中医证型与血清甲胎蛋白(a-fetoprotein,AFP)及血管内皮生长因子(vcular endothelial growth factor,VEGF)之间的相关性。方法:以60例河南中医药大学第一附属医院、河南中医药大学第二附属医院原发性肝癌住院患者为研究对象,标准诊断为PLC,检测并记录各患者血清AFP及血管VEGF的数值,应用PEMS3.0医学统计软件进行统计,计量资料采取t检验、方差分析,多变量分析用多元回归法。结果:①肝气郁结证、气滞血瘀证、肝阴亏虚证、湿热聚毒证的AFP水平依次增高,湿热聚毒证明显增高,各证型间有显著差异。多元回归分析结果显示,中医证型与AFP呈正相关;②肝气郁结证、气滞血瘀证、湿热聚毒证、肝阴亏虚证的VEGF值依次增高,各证之间有显著差异;③AFP与y-谷氨酸转肽酶(y-glutamyl transpeptidese,y-GT)呈正相关,与已有的研究结果"AFP及y-CT均与肝癌的大小相关"一致。AFP在肝癌发生转移时短期内往往会降低,而VEGF主要与肝癌的转移有关,因而出现AFP与VEGF呈负相关;④VEGF与AFP、y-GT呈负相关,说明VEGF与肝癌大小有一定关系,但能否说明VEGF与肝癌大小成反比,尚需进一步的研究。结论:原发性肝癌常见证型与血清AFP及VEGF之间存在显著相关性,可考虑用来指导中医辨证分型。

Objective: To preliminary study on the relationship between common TCM syndromes of primary liver cancer( PLC) and serum a-fetoprotein( AFP) and vascular endothelial growth factor( VEGF). Methods: 60 cases of hospitalized patients with primary liver cancer in the First Affiliated Hospital to Henan University of Chinese Medicine and the Second Affiliated Hospital to Henan University of Chinese Medicine. The standard diagnosis was PLC. The serum alpha-fetoprotein and vascular endothelial growth factor values were detected and recorded in each patient. The statistics were analyzed by PEMS3. 0 medical statistical software. The t-test and variance analysis were used for the measurement data,and the multivariate analysis was used for multivariate analysis. Results:(1)The levels of AFP in qi stagnation syndrome,qi stagnation and blood stasis syndrome,liver yin deficiency syndrome,and damp-heat accumulation syndrome were increased in turn,and the damp-heat accumulation syndrome was significantly higher. There were significant differences among the syndrome types. The results of multiple regression analysis showed that TCM syndromes were positively correlated with AFP;(2)The VEGF values of liver qi stagnation syndrome,qi stagnation and blood stasis syndrome,damp-heat accumulation syndrome,and liver yin deficiency syndrome increased in turn,and there were significant differ-ences among the syndromes;(3)AFP is positively correlated with y-GT and is consistent with the existing findings that both AFP and Y-CT are related to the size of liver cancer. AFP tends to decrease in the short-term of liver cancer metastasis,and VEGF is mainly related to the metastasis of liver cancer,so AFP is negatively correlated with VEGF.(4)VEGF was negatively correlated with AFP and y-GT,indicating that VEGF has a certain relationship with the size of liver cancer,but whether it can be explained that VEGF is inversely proportional to the size of liver cancer,further research is needed. Conclusion: There is a significant correlation between the common syndromes of primary liver cancer and serum abortion protein AFP and vascular endothelial growth factor VEGF,which can be considered to guide TCM syndrome differentiation;Its correlation with the metastasis of liver cancer will be further studied in the future with a large sample size.